Sunday, 14 April 2013

The McKenzie Method & A what weekend in ultra running

I think most readers of this blog will agree when I say - when you have a running injury, don't go to the doctor. At least in my case, the diagnosis and treatment of my injuries have always come with some combintation of massage, yoga, chiropractic, physical therapy and osteopathic medicine.

The thing that the latter practitioners have in common is they 1. take time to hear your story and 2. examine your entire body, looking for asymmetry, tightness, abnormality, etc.

Physicians used to do both of those things really well, but they don't have time now: too many fancy tests to order. But with athletic injuries, there is no need for these tests since the answers can be found with just your eyes, ears and hands.

I've had pain in my right leg since September. I kept running and it got a lot worse in October, so I took a long break. When I returned to running, it hadn't gotten any better. The pattern of my winter was such that I could run short runs, but nothing longer than 15-20 km. Had I gone to a doctor, he would have sent me home with the following advice "stop running" and maybe some ibuprofen. That would have left me fat, depressed, slower and dealing with a stomach ulcer.

The first thing that helped my right hip was taking the shock absorbtion out of my back and hips .I did this through pose running. Trust me when I say that if I can learn a new running style, so can you. We could all benefit from leaning forward more, increasing our cadence and lifting our feet actively.

If you can learn to jump like this, pose running will come very naturally.

Then I went to a physical therapist who had me do this:

This is not me, but had I been demonstrating a back extension in the 80's, I would have worn this outfit.

And I'll be darned if it didn't take the radiating pain down my right leg away. The only drawback is the pain moves to your back. But it is better tolerated here. How and why this happens, I have no clue. I've read some theories about opening up the disc space, but the maneuver also seems to work for non disc injuries with radiating pain.

This treatment was discovered by Robin McKenzie when a patient of his accidently lay himself down for a long time on a table like this, waiting for Dr. McKenzie.

"How's you leg pain", Dr. McKenzie asked (in 1956)?

"I haven't felt this great in weeks!!" responded the man.

But part of the secret is, you have to keep doing these extensions - and in that way, you can keep the pain away for hours or days at a time.

When I ran the Griseløbet 10k, though, I can clearly see now that the pain in my stomach was radiating around from my back after I had just begun using these extensions. The tightness has to go somewhere, but trust me when I say, it is better in the back.

A demonstration of the back extension

and how to determine if the problem is indeed in your disc

Now- what a fun weekend to observe the ultra running world from afar!

1. Meghan Hicks (from Minnesota!) wins Marathon de Sables. Everyone who has met Meghan loves her- even if you've just read her writing (or even her comments here). She is an incredible and thoughtful person who deserved after many years of focused training to win this race. And she did it in style when the first place woman went out too hard on the second to last day (47 miler) and had to drop. Meghan played it calm and smart the whole way and won handily. It even sounded like she ensured medical help for the former first place woman before continuing.

2. What a stacked field at the Lake Sonoma 50 miler. Cassandra Scallon, my bud (from Wisconsin!) had an incredible performance, good enough for the win in 7:47, followed by Joelle Vaught. Amy Sposton showed how consistently she can perform at her peak when she passed Rory Bosio near the end of the race to take 3rd. Good job, Amy!!

15 comments:

Okay, finally watched the videos. It's your piriformis: the most common injury in runners (I have it right now) and for some reason, unknown by doctors who don't treat runners. The first time I had it, I thought it was sciatica, because of the pain radiating down the leg. Second time it was "pseudosciatic nerve compression." Third time, the pain radiated into my testicle and I ended up seeing an urologist and discovered that transcretal ultrasound is really painful and embarrassing.

Finally, I found it hurt most when I'd been sitting for a long time (like the drives to the North Shore) and the standard "baseballer stretch" took care of it. Back extensions help a bit, too.

wow. i feel like i have gotten to know you so well over these past 3 years but it as such a shock to hear your voice... i guess i never really realized that i had not heard your voice before and it was not at ALL the voice i heard in my head when reading your posts. now i KNOW what a midwestern accent is... i mean my husband's family have mid-western accents but i never really thought of them as accents or being midwestern but hearing you talk, now i know... THAT'S a midwestern accent. I LOVE IT!

Same pain in my leg, which made me worried about a tibial fracture for a long time, but then it started radiating in my foot. A PTA student suggested the same stretch and it works, some, or most of the time. I've also started (as a yoga hater), doing non-intimidating yoga, which is also helping. A doctor would have said, 'shin splints,' and 'plantar fasciitis.' Fo sho.

More, please, more excercises!This is exactly how my right glute is behaving (again, again, again) and I'm going to see the osteopath today. I have for once been wise enough to keep quiet for a few days since the acute pain began (I think anyway that it was wise), usually I keep running and then get a real heavy injury...My head is in the same places as Steve's late in a race ;-)

Aw Steve - and you would DEFinitely benefit from sommersaults all the way to the finish line. That is a very impressive way to finish Chippewa, given the massive hill.

I have considered the piriformis as the source of the problem. But I DON'T get why a problem there would be helped so much by back extensions. If I go into physical medicine and rehab, I sure do have a lot to learn. Thanks for the link.

Haha. PPC. You are too funny. This is so hard to convince people of- but living in Denmark has made my "midwestern" accent 10x worse. I mean, Danish sounds like back woods Minnesotan English. My family makes so much fun of me.

And now I would really love to hear you husband's accent. - and yours! Can't you make a video?

Brianne- thanks for your story. Fascinating that these stretches worked for your shin probems, though I am not surprised because my pain was also all the way to my shin.

Probably not a good idea to get me started with yoga since I could go on for AGES about how wonderful it is, but this is something everyone has to disover for themself. (glad you are getting something out of it!)

Btw- if it works "some or most of the time" the extensions should in theory work ALL the time if you do enough of them frequently enough. I know- it's a question of time.

Kirsten- if these extensions work for you, there is no need for me to give you more. Just keep doing them (even 50 at a time if necessary) until the pain is gone. Let me know when the pain is gone in your leg and you only feel it in your back - then we will talk again :o).

Thanks so much for this, I have been having some back pain and then sometimes hip tightness, and now at least I know what it isn't. Which is more than the doctor said before charging me $207. "Just don't run so far."

Hello from Rude Skov

Photo by Stine Sophie Winckel

...

My name is Tracy. I am a physician scientist from the USA, living with my husband and two young boys in Denmark. I work as a post-doc fellow at Næstved Hospital. I have a scientific interest in vision loss, vision loss during exercise, exercise, running during pregnancy, MAF training as well as nutrition and health for athletes. I also have a love for music, physics, statistics, cycling, yoga, cross-country skiing, bla bla bal.

I was a member of Team USA at the IAU World Championships in Ultra Trail Running in 2013 in Wales. I am now training to run with Team Denmark at the IAU World Championships in Annency, France in May 2015.